Trauma to the cornea and sclera is common, but current suturing techniques present limitations. In the case of lacerations that extend to the posterior part of the eye, surgeons have no choice but to leave the wounds open because of difficulty in accessing and closing them with sutures. In other cases, injuries may involve loss of tissue due to avulsion or necrosis, leaving insufficient tissue to effect a suture repair. Likewise, in modern cataract surgery where sutures are often not used the risk of infection remains. [1] A less intrusive technique than suturing might enable such wounds to be closed, thereby improving surgical outcomes. At present there are few alternatives to suture closure of scleral defects, and each has drawbacks. While cyanoacrylate glue has been used, problems such as ease and uniformity of application exist. [2, 3] Fibrin glues suffer from poor tensile strength. [2] Laser tissue welding uses laser energy to cure solder commonly composed of albumin, but its application remains limited due to the lack of consistency in the outcomes, solubility in physiologic fluids, and thermal damage to the underlying tissue. [2] Some promising laser tissue welding research has been performed using biodegradable polymer films [4] and recently using chitosan. [5] Using films instead of solders may make tissue manipulation easier and take less time to complete the laceration closure.
Portions of this material were presented at the Medicine Meets Virtual Reality Conference, Feb. 6-9, 2007, Long Beach Calif., and as posters at the Association for Research in Vision and Opthalmology Annual Meeting Apr. 30-May 6, 2007 in Ft. Lauderdale, Fla.